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midterm > Infection Control > Flashcards

Infection Control Flashcards

1
Q

What are Pathogens?

A

disease producing microorganisms

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2
Q

What are microbes called that are beneficial?

A

Probiotics

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3
Q

What life form is included in microbiology?

A

bacteria, small fungi (molds and yeast), protozoa, certain algae, and viruses.

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4
Q

infection control goals

A 
Goal 1
	Understanding properties of microorganisms
Goal 2
	Understand how microorganisms cause specific diseases
	How to kill the microorganisms
Goal 3
	Preventing disease
	Preventing spread from person to person
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5
Q

Coccus/Cocci:

A

Spherical

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6
Q

Bacillus/Bacilli:

A

Rod-shaped

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7
Q

Spirillum/Spirilla:

A

Curved or spiral cells

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8
Q

Disease transmitted in Dental Office

A

influenza

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9
Q

Blood-borne diseases

A

Hepatitis B and AIDS

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10
Q

Diseases elsewhere in body

A

Measles

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11
Q

Specific oral diseases

A

Herpes infections

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12
Q

Fungi includes

A

mushrooms, molds, and yeast

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13
Q

Candidiasis :

A

Yeast infection
-Thrush
Candida albicans

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14
Q

what scrapes off easily

A

yeast infection

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15
Q

what doesn’t scrape off

A

lucoplaycia

which is also an autoimmune response

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16
Q

the category of bacteria on the hands that refers to the normal skin bacteria rather than the pathogens is called?

A

Resident

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17
Q

what describes the transient skin flora on the hands

A

microbes that are usually involved in the spread of disease from the hands

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18
Q

wearing gloves at chair side helps prevent which of the following routes of entry of patients microbes into the body?

A

percutaneous

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19
Q

mycology is the study of

A

fungi

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20
Q

infection control is

A

controlling microbial contamination and infection

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21
Q

pasteurization is achieved by…

A

heating a fluid to 63’C(145’F) for 30 mins

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22
Q

viruses that infect bacteria…

A

bacteriophage

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23
Q

which agent can cause prion disease

A

special proteins

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24
Q

Bloodborne Pathogens

includes blood borne diseases

  • hepatitis infections
  • tuberculosis
  • hiv/aids
A

may infect different blood cells or other tissues of the body, but during infection the pathogens exit in or are released into the blood or other body fluids.

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25
Q

Hepatitis A –

A

Infectious hepatitis

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26
Q

Hepatitis B

A

– Serum Hepatitis

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27
Q

Hepatitis C –

A

Non A Non B

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28
Q

Hepatitis D –

A

Delta Virus

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29
Q

Hepatitis E –

A

Enteric

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30
Q

Hepatitis G – (HGV) transmitted via blood

A

transmitted via blood

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31
Q

Fluids where bloodborne pathogens can be released include:

A 
Semen
Vaginal secretion 
Intestinal secretions 
Tears
Mother’s milk
Synovial (joint) fluid,
Pericardial (around the heart)fluid
Amniotic fluid (around the developing fetus 
Saliva
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32
Q

which hepatitis is the main concern for health care workers

A

Hep B

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33
Q

Hepatitis B (HBV)

A

It’s an enveloped DNA virus that infects and multiplies in human liver cells
A milliliter of blood can contain as many as 100 million virus particles
Only a small amount is required to transmit disease

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34
Q

Three components of Hep B

A

HBsAg: Hepatitis B Surface Antigen
HBcAg: Hepatitis B Core Antigen
HBeAg: Hepatitis Be Antigen

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35
Q

How are HBV vaccines made

A

from the surface antigen

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36
Q

Hepatitis B (HBV)

A

Can remain viable at room temperature for at least 1 month

Can be killed or inactivated

HBV is more easily killed than Mycobacterium tuberculosis and bacterial spores

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37
Q

Can be killed or inactivated by

A

sterilization: steam autoclave

Disinfection: 
 10 min. exposure to 1:100 diluted bleach
1:16 diluted phenolic glutaraldehyde
75 parts per million (ppm) iodophor
70% isopropyl alcohol
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38
Q

Disease States

A

90% of people infected with HBV will have complete recovery without developing a carrier state

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39
Q

Carrier State:

A

being HBsAg-positive on at lease two occasions when tested

Has potential for spreading disease to others

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40
Q

HBV is spread

A

Percutaneously (through the skin)
Permucosally (through muchous membranes)
Perinatal ( during child birth)

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41
Q

High Risk Behaviors for Acquiring HBV

A

Sharing contaminated needles

Sexual intercourse with an infected person w/o using a condom

Becoming pregnant while infected with HBV

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42
Q

HBV being spread through transfusion is…

A

rare

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43
Q

Fecal-oral route does …

A

not commonly occur

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44
Q

No transmission occurs through

A

Tears
Sweat
Urine
Droplet infection

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45
Q

Symptoms of HBV

A 
Appears 45 to 180 days after exposure
Yellowing of the skin(Jaundice) 
Yellowing of the whites of the eyes
Light colored stools 
Dark urine
Joint pain
Fever, rash, itching
Malaise (not feeling well)
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46
Q

Risk for Dental Team

A

Unvaccinated members 2 to 5 times more likely to become infected

Injuries from contaminated sharps

Blood and saliva contamination

Spraying of blood and saliva into open lesions on skin or onto mucous membranes

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47
Q

OSHA Blood-Borne Pathogens Standard

A

is the most important infection control law in dentistry

It is designed to protect the employees against occupational exposure to blood-borne disease causing organisms i.e. HBV, HCV, and HIV

Requires employers to protect employees from blood and OPIM

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48
Q

Exposure Control Plan

A

Every dental office must have a written exposure control plan that clearly describes how the office complies with the BBP Standard

Must be reviewed and updated annually

Every dental office must have a written hazard communication program

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49
Q

Categories of Employees

A

OSHA BBP Standard requires employers to categorize tasks and procedures during which an employee may be occupationally exposed.

Occupational exposure

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50
Q

Occupational exposure

A

Any reasonably anticipated skin, eye, mucous membrane contact, percutaneous injury with blood of OPIM

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51
Q

Category I of employees

A

Routinely exposed to blood saliva or both

Dentist, dental assistant, dental hygienist, laboratory technician

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52
Q

Category II of employees

A

May on occasion be exposed to blood, saliva or both

Receptionist, office manager who may clean rooms

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53
Q

Category III of employees

A

Never exposed to blood saliva, or both

-Financial manager, insurance clerk, computer operator

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54
Q

Post-exposure Management

A

If an incident occurs:

BBP Standard requires the employer to have a written plan
Plan explains exactly what steps the employee must take
The employer must provide training to employees on the proper response to an exposure incident

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55
Q

BBP Standard requires

A

the dentist/employer to provide training in infection control procedures and safety issues to all personnel who may come into contact with blood, saliva or OPIM

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56
Q

Employer must keep record of training

A

Date
Topic
Names of all who attended

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57
Q

Employee Medical Records

A

The dentist/employer must keep a confidential medical record for each employee
Records stored in locked file
Must be maintained for duration of employment plus 30 years

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58
Q

Classification of Waste

A

OSHA regulations apply to the handling of waste in the dental office for the protection of employees.

EPA regulations apply for waste when it leaves the office, and to its disposal

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59
Q

All dental waste should be classified according to EPA guidelines as

A

Regulated

Non-regulated

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60
Q

Regulated waste includes:

A

Sharps (EPA classified Infectious waste)

Blood

Extracted teeth

Toxic waste

require special disposal

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61
Q

Sharps (EPA classified Infectious waste)

A

Disposable needles, scalpel blades, contaminated broken glass, disposable dental burs, endodontic files and reamers, and orthodontic wire

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62
Q

Blood

A

, blood-soaked and blood-caked items, human tissue, and pathologic waste

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63
Q

Toxic waste:

A

can have a poisonous effect

Must be labeled with biohazard symbol

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64
Q

Biohazard Warning Label

A

Fluorescent orange or red orange

Biohazard symbol

Word biohazard attached to

  • Regulated waste
  • Refrigerators or freezers containing blood or OPIM
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65
Q

Non-regulated waste includes:

A

Contaminated waste materials i.e.
Saliva soaked gauze
Used patient bibs
Surface barriers

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66
Q

All waste containers that hold potentially infectious materials (whether regulated or non-regulated) must be labeled with the ____ ____

A

biohazard symbol.

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67
Q

non regulated waste

A

general

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68
Q

medical waste (regulated)

A

contaminated and infectious

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69
Q

chemical waste (regulated)

A

hazardous and toxic

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70
Q

Handling Hazardous Materials

A

Materials would include, but are not limited to:

Outdated x-ray solutions
Vapor sterile
Lead foil from x-ray packets
Scrap amalgam/mercury
Glutaraldehyde solution with concentration higher the 2%
71
Q

Preventing Sharps Injury by establishing a “Culture of Safety”

A

Culture refers to factors that influence overall attitudes and behavior in the office

A Safety Culture reflects the shared commitment of the employer & employees toward ensuring the safety of the work environment.

72
Q

Safety Syringes

A

included in the changes in the Engineering Controls to include devices which are engineered with injury protection and needleless systems

73
Q

Disinfection

A

Eliminates many or all pathogenic microorganisms, with the exception of bacterial spores

74
Q

Sterilization

A

Complete elimination or destruction of all forms of microbial life including bacterial spores

75
Q

Asepsis

A

Prevention of contact from pathogens:

-Includes disinfection, sterilization and all other measures

76
Q

Antiseptic

A

Germicide used on skin or living tissue for the purpose of inhibiting or destroying microorganisms

77
Q

Classification of Patient Care Items

A

Based upon the risk of transmitting infection if the item becomes contaminated during use

78
Q

Instruments are Classified as:

A

Critical
Semi-critical
Non-critical

79
Q

Mandates of Sterilized Items

A

CDC, ADA and OSAP mandated that all critical and semi-critical dental instruments that are heat stable be sterilized by:

Autoclaving: steam under pressure
Dry Heat
Chemical Vapor

80
Q

Critical Items

A

Instruments used to perform invasive procedures

Come in direct contact with soft or bony tissues

Can cut or penetrate tissue

81
Q

critical items must be ____ sterilized

A

heat

82
Q

examples of heat sterilized instruments

A

explores, scalpels, surgical forceps, bone chisels

Handpieces, manual cutting instruments, burs

83
Q

Semi-Critical

A

Instruments not intended to penetrate oral soft or hard tissues but may come into contact with oral tissue

Instruments should be heat sterilized when possible

Can use high-level disinfectant

84
Q

what is a high level disinfectant

A

(Glutaraldehyde) – chemical disinfectant that is used as a cold sterile for items that cant withstand heat

85
Q

semi-critical instruments include

A

Amalgam condensers, amalgam carriers, plastic instruments

Dental dam frame, mouth mirrors

86
Q

Non-critical Items

A

Instruments that do not come into direct contact with body fluids

May contact intact skin or working surfaces

Not used directly in the mouth

87
Q

non-critical items include

A

Medicament jars, cavity liners, unit tubing, restorative materials, positioning device to x-ray machine, blood pressure cuff, stethoscope

88
Q

noncritical items Items should be sanitized or cleaned using an intermediate or low-level disinfectant

A

bleach and water

89
Q

Seven Steps for Instrument Processing

A
  1. holding (presoaking)
  2. pre cleaning
  3. Corrosion Control, drying, lubrication
  4. packaging
  5. Sterilization or high level disinfection
  6. Sterilization monitoring
  7. Handling processed instruments
90
Q

Holding (Presoaking)

A

Facilitates the cleaning process by preventing debris from drying.

91
Q

Precleaning

A

Removes as much of the bioburden as possible to give the subsequent sterilization step the best chance to work . Which types? Blood, saliva, tissue

92
Q

Corrosion Control, drying, lubrication

A

Reduces damage to instruments and helps ensure proper functioning of the instruments

93
Q

Packaging

A

Helps maintain sterility of instruments after sterilization and before they are presented to a patient

94
Q

Sterilization or high level disinfection

A

Kills all microbes remaining on the instruments to help ensure patient safety.

95
Q

Sterilization monitoring

A

Measures the use and functioning of the sterilizer

96
Q

Handling processed instruments

A

Helps maintain the sterility of the instruments during storage until they are used on a patient

97
Q

what are some Hands free Mechanical Devices

A

ultrasonic cleaners and automatic washers/disinfectants

98
Q

Ultrasonic Cleaners

A

Loosen and remove debris from instruments
Reduce risk of hand injury
Puncture resistant utility gloves and PPE used
Works by production of sound waves through cavitation and implosion of bubbles

99
Q

Automatic Washers/Disinfectors

A

FDA approved appliance
Classified as thermal disinfectors
Subjects instruments to level of heat that kills most vegetative microorganisms

100
Q

Steam Autoclave

A

Used to sterilize dental instruments
Uses steam and pressure
Operates through four cycles

101
Q

4 cycles of the steam autoclave

A 
Heat-up cycle
Sterilizing cycle
-2500 F (1210 C) for 30 minutes
Depressurization cycle
Also known as the vent cycle
Drying cycle
102
Q

advantages of the steam autoclave

A

Short time
No corrosion
Instruments dry quickly following cycle

103
Q

disadvantages of the steam autoclave

A

Damages some plastic and rubber items
Requires use of distilled water
May rust non-stainless steel instruments and burs
Cannot use closed containers

104
Q

STAT/M Sterilizer

A

“Flash” Sterilization of unpackaged instruments using short exposure times. (2730 F for 3 minutes)

105
Q

Sterilization Failures

A 
Inadequate Instrument Cleaning
Improper packaging
Improper loading of sterilizer
Improper timing
Improper temperature
Improper Method of Sterilization
106
Q

Sterilization Monitoring

A

Mechanical (Physical) Monitoring
Chemical Monitoring
Biologic Monitoring

107
Q

Biologic Monitoring

A

Also known as spore testing
Determines if endospores have been killed
Provides the main guarantee of sterilization

108
Q

Chemical Monitoring

A

Process indicators (external)
Located on outside of instrument packs
Identify instrument packs exposed to certain temperatures
Also known as single-parameter indicators
Indicates processed vs. unprocessed packs

109
Q

Mechanical (Physical) Monitoring

A

Looking at gauges and readings on sterilizer

Recording temperatures, pressure, exposure time

110
Q 
Chemical Monitoring,
Process Integrators (internal)
A

Placed inside the instrument packages
They respond to a combination of pressure, temperature and time
Also known as multi-parameter indicators
All sterilization factors are integrated
Includes: strips, tabs and tubes of colored liquid

111
Q

Integrator Strips

A

Used inside packs to monitor time, temperature and pressure

112
Q

Biologic Monitoring

A

The CDC, ADA and OSAP recommend at least weekly biologic monitoring of sterilization equipment.
Biologic indicators (BIs) are also known as spore test
can be vials or strips of paper containing harmless bacterial spores

113
Q

high speed handpiece runs at

A

400,000rpm

114
Q

Blood, saliva and tooth fragments can lodge in heads

Dental handpieces must be properly cleaned and heat-sterilized by

A

flushing and sterilization techniques

115
Q

Flushing Techniques

A

Attach to pressurized handpiece cleaner
Blow out using compressed air
Flush for approximately 25 sec. at end of each appointment

116
Q

Sterilization Techniques

A

Steam are chemical vapor sterilization recommended
Packaged in bags, wraps or packs
Temperatures should not exceed 2750F (1350C)
Never run HP “hot” or cool down with water

117
Q

Sterilization of Heat-Labile Items

A

Reusable items that cannot withstand heat sterilization

Liquid sterilant/high-level disinfectant

118
Q

Reusable items that cannot withstand heat sterilization:

Examples

A

Some plastics, dental dam frames, shade guides, rulers, x-ray collimating devices

119
Q

Liquid sterilant/high-level disinfectant

A

2.0% - 3.4% Glutaraldehyde
or
7.0% Hydrogen peroxide
Requires 3-12 hour contact time

Glutaraldehyde requires 10-hr contact time

120
Q

Disadvantage of Sterilization of Heat-Labile Items

A

No way to perform biological monitoring

121
Q

1/3 of those infected with ___ have recognizable symptoms

A

Hep B

122
Q

safety data sheet

A

describes the properties and potential hazards of chemicals

123
Q

which is not considered as regulated waste in dentistry?

a) extracted teeth
b) used face mask
c) non sharp solids
d) sharps contaminated with blood or saliva

A

b) used face mask

124
Q

which is considered regulated waste?

a) used plastic surface barrier
b) used sterilization wrap
c) used scalpel blade
d) cotton roll damp with saliva

A

used scalpel blade

125
Q

which is regulated waste in a dental office?

a) used patient bib
b) a 2x2 gauze pad with drops of blood
c) double ended scaler with broken tip
d) used exam gloves

A

double ended scaler with broken tip

126
Q

OSHA requires sharps container to be?

a) made of glass
b) leak proof
c) reusable
d) securely attached to a wall

A

leak proof

127
Q

sharps containers should have which of the following properties?

a) be made of glass
b) clear, see through plastic
c) reusable after contents are emptied
d) be made to be closed

A

be made to be closed

128
Q

which can be thrown in the regular trash even if its contaminated with a little saliva?

a) broken anesthetic carpules
b) injection needles
c) cotton rolls
d) burs

A

cotton rolls

129
Q

most regulated medical waste in dental office consists of?

a) liquid blood and contaminated sharps
b) contaminated sharps and extracted teeth
c) non liquid solids saturated with blood or saliva and extracted teeth
d) non liquid solids saturated with blood or saliva and liquid saliva

A

contaminated sharps and extracted teeth

130
Q

what the best way to dispose of a contaminated needle?

a) pass it to someone else for disposal
b) cut the needle and place it in sharps container
c) place the needle in sharps container as soon as possible
d) bend the needle and place in sharps container

A

place the need in sharps container as soon as possible

131
Q

which should be done before disposing of a used anesthetic needle?

a) bend the needle
b) pass to someone else for recapping
c) recap needle by hand
d) recap the needle with scoop technique

A

recap with scoop technique

132
Q

how to do you pick up a dropped anesthetic needle on the floor with a patient?

a) pick it up and place on instrument tray
b) put on utility gloves, pick it up and place in sharps
c) use tongs or cotton pliers to pick it up and place on instrument tray
d) use tongs or cotton pliers to pick up and place in sharps

A

use tongs or pliers to pick up and place in sharps

133
Q

sharp containers should be?

a) occasionally drained to remove any liquid
b) filled only 3/4 full before disposing
c) emptied and reused
d) kept in sterilizing room

A

filled 3/4 full before disposing

134
Q

when could a sharps injury most likely occur?

a) cleaning and disinfecting a counter top
b) operating the dry heat sterilizer
c) using a biological indicator
d) inserting a bur into handpiece

A

inserting a bur into a handpiece

135
Q

when could a sharps injury most likely occur?

a) operating the autoclave
b) cleaning and disinfecting a counter to
c) handling sterile packs of hand instruments
d) using a biological indicator

A

handling sterile packs of hand instruments

136
Q

when could a sharps injury most likely occur?

a) placing patient bib
b) using a biological indicator
c) hand instruments are placed back into instrument tray
d) using the HVE

A

hand instruments are placed back into instrument tray

137
Q

what is engineering control?

A

a devise that removes the potential hazard

138
Q

what is work place control?

A

an action that alters the manner in which a task is performed

139
Q

what is the safest approach to cleaning and managing contaminated hand instruments ?

  • ultrasonic cleaning in instrument casset
  • hand scrubbing
  • ultrasonic cleaning in cleaning basket
A

ultrasonic cleaning in instrument casset

140
Q

employees who are routinely exposed to blood and OPIM are placed in the following category?

I
II
III
IV

A

category I

141
Q

what does OPIM mean

A

other potentially infectious materials

142
Q

the goal of the ___ ___ ____ is to ensure employees and employers know about work hazard and how to protect themselves

  • hazard communication program
  • work practice control
  • exposure control plan
A
  • hazard communication program
143
Q

the main directive of OSHA is protect who?

A

the employee

144
Q

containers that are received from the MANUFACTURER ____ need to be relabeled?

A

does not

145
Q

waste that leaves the dental office is regulated by?

  • OSHA
  • EPA
  • OSAP
  • CDC
A

OSHA

146
Q

which microbes are not killed by intermediate level disinfectants?

  • bacterial spores
  • tuberculosis agent
  • neither
  • both
A

both

  • bacterial spores
  • tuberculosis agent
147
Q

what antimicrobials agents can be used on the floor

A

low level disinfectant

148
Q

what antimicrobial agents should not be used for surface disinfection in dentistry?

sterilant/ high level disinfectant
low level disinfectant
intermediate level

A

sterilant/ high level disinfectant

149
Q

what agent is not tuberculocidal

phenolic
glutaraldehyde
iodophor
windex

A

windex

150
Q

why should disinfectants used on clinical contact surfaces contaminated with blood or saliva have tuberculodial activity?

A

bc the tuberculosis agent is one of the more resistant microbes to kill. tuberculocidal activity indicates sufficient potency to kill most other negative microbes

151
Q

liquid sterilants, gluteraldehyde, should be used only on reusable items that can be submerged and are?

A

heat sensitize

152
Q

the use of a disenfectant type cleaner to pre clean a contaminated operator surface:

  • starts the microbial killing process and helps protect the person doing the cleaning
  • should not be done
  • is necessary overtime a surface cover is removed
  • eliminates the need to followup with a disenfectant wipe
A

-starts the microbial killing process and helps protect the person doing the cleaning

153
Q

when can a liquid sterilant achieve sterilization

  • sterilization will only occur when the solution is used only for the longer exposure time
  • sterilization will only occur when the solution is used at a temperature about 121’C/ 250’F
A

-sterilization will only occur when the solution is used only for the longer exposure time

154
Q

touch surfaces are …

  • used minimally throughout the procedure
  • used continually thoughout the procedure
  • are never touched
A

-used minimally throughout the procedure

155
Q

glutaraldehyde is a _____ level disenfectant/sterilant

A

high

156
Q

high level sterilants take _ hours to sterilize an instrument

A

6-10 hours

157
Q

a hospital level disinfectant will…

A

inactivate the polio 2 and tuberculosis bacteria

158
Q

how do you sterilize a rubber dam

A

a liquid sterilant aka gluteraldehyde

159
Q

the purpose of the aluminum foil test is to

A

determine whether an ultrasonic cleaner chamber has an even distribution of sonic energy

160
Q

the ultrasonic cleaner works by

A

sound waves and implosion

161
Q

kitchen dishwasher cannot be used to pre clean bc they are not ____ approved

A

FDA

162
Q

the temp recommend for the steam autoclave is

A

250 degrees for 30 minutes

163
Q

where is the process indicator placed

A

outside the package

164
Q

another term for spore testing is

A

biologic monitoring

165
Q

what kind of heat sterilization is appropriate for high speed handpieces

A

steam and chemical vapor

166
Q

process integrators are also knows as

A

combination indicators

167
Q

in flash autoclaves unpackaged instruments can be processed using short exposure times at…

A

273 degrees for 3 minutes

168
Q

microbes spreading from a patients mouth to your hand and then to another patients mouth represents what type of spread from patient to patient

A

indirect contact

169
Q

during development of an infectious disease what should happen before the step ‘ spread to a new host’

A

escape from current source

170
Q

the incubation stage of an infectious disease occurs

A

after contamination and before symptoms

171
Q

infection is best described as

A

growth and survival of microbes on or in the body

172
Q

what bacterial structure protect the cell from being crushed

A

cell wall

173
Q

bacteria that can survive and grow in the presence of acids are call

A

aciduric

174
Q

bacteria that die in the presence of oxygen are called

A

anaerobic

midterm (4 decks)

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